HomeMy WebLinkAbout321 S Liberty St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
1JI.-U-2-0ot--18a 7-
REQUEST
Date LI- ?-l/_ D L Time
/
Received by
(phone, person)
Location of Work to be inspected 3 ~ I ~ b -f d~ ) f-
Name of person requesting inspection T {AJ -I I (~I
Address of person requesting inspection I 7 + It '&. Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other (A. JC{ t-c lr
INSPECTION NOTES
Inspected
Remarks
Date Time
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By
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YES NO
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RESTORATION REQUIRED
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
OPCC
DOther -~p S b I L
,
) 73'S 7
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
... ~.", ::~::Yr:-'
ow,200 '=I - 18 .3 T
City of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
'Work Order No:
DATE REPORTED
193 1
L/.-- II ~ 0 I
'Crew:
-) I (
. (
REPAIR LOCATION
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY K OTHER 0
DATE OF REPAIR. [1- ^ q - C( TIME
J ~ \
d-.I( file
DA.M. DP.M.
L'~Y+\.I
r
ADDRESS
TYPE OF MAIN
SIZE.
DEPTH OF MAIN
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED:
MAIN JOINT 0 CIR BREAK 0 SPLIT BELL D LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE. TAP 0 CORP STOP D PIPE ~ CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPD DRESSERO OTHER
SITE CONDITION GRAVEL D AS~ljALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA ld SOIL TYPE
CUTS. ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION. INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXlERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
cm.ORINE RESIDUAL SAMPLE / C)) P.P.M.
WATER OFF FROM r I { ~ 0 It. TO J?- f M.
}htJU5Z
J h r ( QUfCl9-Z
FROM M. TO M.
APPARENT CAUSE OF LEAK. U tU k h (J L0 V\